Harm reduction features in drug policy debate but not United Nations commission session

When Ambassador William Brownfield spoke at the recent 57th session of the Commission on Narcotic Drugs in Vienna, he laid out four basic principles of international drug policy. In short, they were to:

Defend the existing three international agreements (made between 1961 and 1988) on control of narcotic use and trafficking,

Interpret those with flexibility as living documents in a changing world,

He repeated those four principles today, at a discussion to “Focus on International Drug Policy” at the Center for Strategic and International Studies, to report that they were well received. At a time when drug control approaches have reached a turning point that has recently seen the battle-leader of the 40-year “war on drugs” become home to two states where recreational marijuana use is now legal, Brownfield, who is U.S. Assistant Secretary of the Bureau of International Narcotics and Law Enforcement Affairs, was pleased to find consensus.

Dr. Michel Kazatchkine

Dr. Michel Kazatchkine, currently United Nations Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, though, was at the same gathering in Vienna, and for him, the event fell short. Kazatchkine, who also has served on the Global Commission on Drug Policy, as well as having led the Global Fund to Fight AIDS Tuberculosis and Malaria, had hoped for a look at what policies have achieved, and left in their wake so far. The Global Commission has issued three reports answering some of those questions. The first report concluded the global war on drugs has failed, the second two concluded that drug policies stemming from that “war” have fueled HIV and Hepatitis epidemics. “Not to mention tuberculosis,” Kazatchkine added before an audience today. For all of that, Kazatchkine said, the scientific evidence supporting the effectiveness of harm reduction measures, including opioid substitution therapy and syringe exchanges, in addressing the public health impacts of narcotic drug use did not earn mention in the Vienna gathering’s concluding document.

Kazatchkine joined Brownfield at the Washington, DC discussion today, along with Ruth Dreifuss, former President of the Swiss Confederation, and former head of the Swiss Department of Home Affairs, which oversees both public health and drug policies, and Dr. Kevin Sabet, director of the Drug Policy Institute at the University of Florida, who addressed domestic drug policies.

Dreifuss, also a member of the Global Commission on Drug Policy, described the harm reduction measures adopted by her country, when “we were confronted with an explosion” of HIV among populations that laws had pushed to the edges of society. The measures included collaborative efforts with law enforcement, government services, and courts to reach more people with treatment. But, she added, for large numbers of people, treatment aimed at abstention is ineffective, “so we had to extend substitution therapy.” In addition, she said, “we had to look at people who could not comply with the services we were providing.” For those, she said, heroine prescription, as well as syringe exchanges, were added to the measures.The results were encouraging she said. People returned to their communities and even to work.

“Everyone can agree, with your four pillars,” Dreifuss told Brownfield. “They are very reasonable.”

Except she added, for the part about tolerating policies that include labor “treatment” camps, that keep pain medicine out of the hands of the dying patients, that keep people in prison powerless to protect their health, “If I see such kind of interpretation,” she said, “I feel there is strong harm from aggressive interpretations of drug policies. I can’t agree that’s okay.”